Provider Demographics
NPI:1467062489
Name:ARRAIZ, ALICIA M (RDH)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:M
Last Name:ARRAIZ
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:M
Other - Last Name:HERZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDH
Mailing Address - Street 1:5605 RIGGINS CT STE 101A
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-6575
Mailing Address - Country:US
Mailing Address - Phone:775-737-1773
Mailing Address - Fax:
Practice Address - Street 1:5605 RIGGINS CT STE 101A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6575
Practice Address - Country:US
Practice Address - Phone:775-737-1773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV101824124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV880411192Medicaid